ABSTRACT : There is a huge economic burden of diabetes in South Carolina.
: The South Carolina Guidelines for Diabetes Care were based on the 2013 Standards of Medical Care from the American Diabetes Association.
: From a review of the Diabetes Quality Indicators in South Carolina 2007, Medicare claims data show: 65% of South Carolinians with diabetes insured by Medicare received 2 A1C test per year, 54% received an eye examination and 78% received a lipid panel. Only 42% of these individuals with diabetes had all 3 tests in the same year. In addition, only 50% of individuals with diabetes in South Carolina attended a diabetes self-management class. To improve the statistics and outcomes, the Diabetes Advisory Council provided the evidence-based South Carolina Guidelines for Diabetes Care. They are based on the 2013 Standards of Medical Care from the American Diabetes Association. These guidelines have been promoted at the continuing education programs sponsored by the Diabetes Initiative of South Carolina and the South Carolina Division of Diabetes Prevention and Control and distributed in the community sites by the Racial and Ethnic Approaches to Community Health coalition.
: The South Carolina Guidelines for Diabetes will provide evidence-based therapy and monitoring to minimize complications from diabetes and promote a higher quality of life for those with diabetes.

[Show abstract][Hide abstract]ABSTRACT:
The clinical management of individuals with type 2 diabetes mellitus (T2DM) in primary care is a challenge both to the novice and the experienced clinician. This article reviews the latest evidence-based guidelines and focuses on how to incorporate them into the primary care setting for adults already diagnosed with T2DM.

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The 2012 update of the Kidney Disease Outcomes Quality Initiative (KDOQI) Clinical Practice Guideline for Diabetes and Chronic Kidney Disease (CKD) is intended to assist the practitioner caring for patients with diabetes and CKD. Substantial high-quality new evidence has emerged since the original 2007 KDOQI guideline that could significantly change recommendations for clinical practice. As such, revisions of prior guidelines are offered that specifically address hemoglobin A(1c) (HbA(1c)) targets, treatments to lower low-density lipoprotein cholesterol (LDL-C) levels, and use of angiotensin-converting enzyme inhibitor (ACE-I) and angiotensin receptor blocker (ARB) treatment in diabetic patients with and without albuminuria. Treatment approaches are addressed in each section and the stated guideline recommendations are based on systematic reviews of relevant trials. Appraisal of the quality of the evidence and the strength of recommendations followed the Grading of Recommendation Assessment, Development, and Evaluation (GRADE) approach. Limitations of the evidence are discussed and specific suggestions are provided for future research.

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